10,11 In a study from February 2000 over a period of a year in Gambia, hypertension and smoking were the most prevalent risk factors of stroke.12 Uncontrolled hypertension is one of the major causes of see more stroke in Latin America, but other risk factors such as

heavy alcohol consumption and smoking also play a role.13 Diabetes, as a major risk factor of stroke, has been reported in 2-10% of the population in tropical areas.14 Inhibitors,research,lifescience,medical The prevalence of diabetes in South Africans older than 30 years is 5.5%. Ten percent of stroke patients in adult males and females over 30 years were attributable to diabetes.15 In one study in sub-Saharan Africa, stroke was accounted for approximately Inhibitors,research,lifescience,medical 30% of all diabetic deaths.16 The relationship between stroke and high serum levels of low density lipoprotein (LDL) has been shown in several studies. Overall, about 29% of ischemic stroke burden in adult males and females more than 30 years were attributable to hypercholesterolemia with marked variation by population

group. High cholesterol was estimated to cause 4.6% of all deaths in South Africa in year 2000.17 Dyslipidemia was commonest in whites (37%), but least common in blacks (5%).9 Obesity was present in 44% of stroke patients in Burkina Faso.18 Smoking is an increasing problem in the population at risk. It has an additive effect on the other risk factors. Inhibitors,research,lifescience,medical The prevalence of current smoking and ever smoking were 3.0% and 15.6%, respectively in Malawi.19 The prevalence of smoking in 33 countries of Western Pacific and South Inhibitors,research,lifescience,medical East Asian regions ranged 28-82% in males and 1-65% in females. The percentage of haemorrhagic stroke attributable to smoking ranged 4-12% in males and 1-9% in females.20 Risk factors Inhibitors,research,lifescience,medical other than smoking increased with

age in a study done in Sub-Saharan Africa.9 Pregnancy and oral contraceptives (OCP) consumption are important risk factors for venous infarction, especially in early postpartum period.21,22 There is not any published data about the effect of OCP in Sub-Saharan Africa. Positive past history of stroke, cardiac diseases, obesity, and lack of physical exercises are other important risk factors. Between 4-10% of patients had a positive past history of stroke and up to 11% had a history of transient ischemic attack (TIA). In only 22% of patients Dichloromethane dehalogenase an atherosclerotic plaque in major extracranial vessels is shown. 21,22 Cardiac emboli in young adults due to rheumatic heart disease are more prevalent than coronary artery diseases in African patients.3 It was reported that 22% of strokes were attributed to physical inactivity.23 Forty-five percent of ischemic strokes were attributed to excess body weight.24 The main mechanisms for the cerebrovascular diseases in tropical countries are the same as those in other areas, but it is estimated that between 6 to 12% of the vascular accidents had other unusual etiologies.